Narcissistic personality disorder is often diagnosed with other mental health disorders (such as the Borderline, Histrionic, or Antisocial personality disorder). This is called "co-morbidity". It is also often accompanied by substance abuse and other reckless and impulsive behaviours and this is called "dual diagnosis".
But there is one curious match, now this has been documented by various medical and psychological research journals (ill put the references below in the description box): narcissism and the Schizoid Personality Disorder.
Schizoid personality disorder (SPD) is a personality disorder characterised by a lack of interest in social relationships, a tendency towards a solitary or sheltered lifestyle, secretiveness, emotional coldness, detachment, and apathy. Affected people may be unable to form intimate attachments to others and demonstrate a rich and elaborate internal fantasy world.
SPD is not the same as schizophrenia or schizotypal personality disorder, but there is some evidence of links and shared genetic risk between SPD, other cluster A personality disorders, and schizophrenia. Therefore, SPD is considered to be a "schizophrenia-like personality disorder".
People with schizoid personality disorder are often aloof, cold, and indifferent, which causes interpersonal difficulty. Most individuals diagnosed with SPD have trouble establishing personal relationships or expressing their feelings meaningfully. They may remain passive in the face of adverse situations. Their communication with other people may be indifferent and tense at times. Because of their lack of meaningful communication with other people, those who are diagnosed with SPD are not able to develop accurate impressions of how well they get along with others.
The narcissist is known to experience hallucinations auditory or visual stimuli that is not there and is a figment of imagination for ego processes. Which is also known to happen in schizophrenia.
What are delusions and hallucinations?
A delusion is "a false belief based on incorrect inference about external reality that is firmly sustained despite what almost everyone else believes and despite what constitutes incontrovertible and obvious proof or evidence to the contrary".
A hallucination is a "sensory perception that has the compelling sense of reality of a true perception but that occurs without external stimulation of the relevant sensory organ".
Delusion is, therefore, a belief, idea, or conviction firmly held despite abundant information to the contrary. The partial or complete loss of reality test is the first indication of a psychotic state or episode. Beliefs, ideas, or convictions shared by other people, members of the same collective, are not, strictly speaking, delusions, although they may be hallmarks of shared psychosis.
The different types of delusions are:
2. grandiose - magical thinking
3. referential (ideas of reference) HALLUCINATIONS, AUDITORY, GUSTATORY, OLFACTORY, SOMATIC, TACTILE, VISUAL
basically all the senses are out of control, out of sync with one another.
Narcissistic individuals have developed the capacity to inflate, expand upon and intensify their strengths. They learn to lead with them in such manner that their experience of feeling small or vulnerable is masked by the presentation of just the opposite. The implication here is not that the narcissist's strengths are a sham; but more, that the narcissist is strongly invested in his or her strengths because they are employed in the service of protecting or buttressing the self against the experience of insufficiency. Temporarily, all are fooled by this compensatory counterbalance, including the individual behind the narcissistic mask.
This is what a few studies have come to conclude about the disorder:
No. Schizophrenia is an axis 1 thought disorder characterized by psychosis. Narcissism is an axis 2 cluster b personality trait. It is possible to have one, the other one, both or neither.
Schizophrenia. No correlation between the psychosis of schizophrenia & the personality disorder narcissistic personality, however, the two can coexist.
No. Narcissism is a personality disorder, featuring grandiosity, egomania, devaluation and objectification of others, feelings of specialness and entitlement. Schizophrenia is one of the psychotic disorders, featuring (typically) auditory and visual hallucinations (and less frequently tactile, gustatory, and olfactory hallucinations.
Possibly. There are a number of possible connections. The most important one is that any chronic disease (such as schizophrenia) is likely to make you more preoccupied with yourself (and thus make you seem narcissistic). In addition, schizophrenia, which is primarily a disorder of unusual brain connections, makes people think in ways that are very personal and don't make sense to others.
The basic dynamic of this particular brand of co-morbidity exists in these particular ways:
The Narcissist feels superior, unique, entitled and better than another person. They tend to despise them, to hold them in contempt and to regard them as lowly and subservient beings.
The narcissist is DEPENDENT on input from other people for the performance of certain ego functions (such as the regulation of his sense of self worth). Without narcissistic supply (adulation, adoration, attention), the narcissist shrivels and withers and is dysphoric (=depressed).
The narcissist resents this dependence, they are furious at themselves for neediness and - in a typical narcissistic manoeuvre (called "alloplastic defence") - he blames OTHERS for his anger.
Many narcissists are paranoids. This means that they are afraid of people and of what people might do to them. Think about it: wouldn't you be scared and paranoid if your very life depended continually on the goodwill of others? The narcissist's very life depends on others providing him with narcissistic supply. He becomes suicidal if they stop doing so.
To counter this overwhelming feeling of helplessness (=dependence on narcissistic supply), the narcissist becomes a control freak. They sadistically manipulates others to their own needs.
As you can see, the narcissistic is full of contradictions of their being… a confusion exists. The Narcissist depends on people - but hates and despises them. Wants to control them unconditionally - but is also looking to punish himself savagely. He is terrified of persecution ("persecutory delusions") - but seeks the company of his own "persecutors" compulsively.
I think that Schizophrenia is maintained by an unskilful dialogue between narcissism and jealousy. I classify the disorder under narcissism since the defences that the person creates to protect themselves are created within their own narcissistic bias.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Revised.
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition
Center for Substance Abuse Treatment. Assessment and Treatment of Patients with Coexisting Mental Illness and Alcohol and Other Drug Abuse. Treatment Improvement Protocol (TIP) Series, No.9.
National Institutes of Health - National Library of Medicine
Caligor, E., Levy, K. N., & Yeomans, F. E. (2015). Narcissistic personality disorder: diagnostic and clinical challenges. American Journal of Psychiatry, 172(5), 415-422